Bucks uses the email address you provide to send you personalized and confidential information about you, such as your student number and application status. It is your responsibility to provide us with an email address that is correct, secure and private.

Primary Email Address *

Type "YES"
in the box below to certify that you are granting permission for Bucks to send personally identifiable and confidential information about you to the email address you have provided:

Primary Phone (with area code) *xxx-xxx-xxxx

Type *

Alternative Phone (with area code)

Type

Citizenship Status

Social Security Number: *

NOTE: If you cannot or do not wish to provide your social security number on this form, note that processing of your financial aid application may be delayed.

Are you a US Citizen? *

If you are NOT a US Citizen: *

Country of Citizenship:

Immigration Status

Permanent Resident / Asylee / Refugee -
"A" Number:

Non-Permanent Resident

Visa Type:

Notes: If you are not a US Citizen, your application will remain incomplete until you forward copies of your
immigration documents to the Admissions Office.

All visa holders are subject to out-of-state tuition rates, due to Commonwealth of Pennsylvania guidelines.

Veteran Status

Are you a veteran?

Your Employer

Employer/Company Name:

Your Job Title

Company Address

Company Address Line 2

City

State

Zip

-
(plus 4)

Phone

Emergency Contact

Contact Name:

Relationship:

Phone

Education Information...

Your Educational History

High School *

HS Graduation Year
(yyyy)

If your High School was not specifically listed,
enter its city and state here:

City:

State:

Current and/or Previous Colleges (most recent first)

NOTE: Bucks does NOT automatically evaluate transcripts for prerequisite waivers and/or transfer credit. By default, transcripts are evaluated only to determine whether you must complete placement testing at Bucks.

For each school below, indicate whether you are
having an official transcript sent and whether you wish that transcript evaluated for prerequisite waivers and/or potential transfer credit. Details on this process can be found at the Transfer Page (link opens new window).

Institution

SendingTranscript

Eval.for Credit or Prereqs.

Did yougrad.?

Years Attended
(from -
to)

Credits Earned

1

2

3

4

Your Plans At Bucks County Community College

Enrollment Term *

Enrollment Year *

Status *

Are you a high school student who wants to take college classes before graduating HS? (early admission) *

Planned Major *Note: If applying for Special Enrollment Status, select AA.0099

Primary Educational Goal *

Do you have a specific career goal? *

What Was Your Primary Influence In Choosing Bucks County Community College?

Certification of Application

I certify that the information on this application is complete and accurate in every respect. I realize that failure to provide accurate and/or complete information can result in cancellation of this application, and/or revocation of admissions.

Type "YES" to certify your application: *

Services Available

Perkins Academic Support Services are available through the Carl D. Perkins Grant to students seeking Occupational Degrees and Certificates. Eligible students must be single parents, displaced homemakers, academically or financially disadvantaged, or speak English as a second language. Please contact the PASS Office at 215-968-8140 for details of services available.

Disability Services determines and guides the academic adjustments required for the College to comply with Section 504 and the Americans with Disabilities Act (ADA). Students are encouraged to contact this Office prior to enrollment in order to identify needed adjustments and determine eligibility. Contact the DS Office by phone at 215-968-8463 (V), 215-504-8561 (TDD).

Multicultural Student Services develops and implements programs and services for recruitment, retention, and education of under-represented minority groups and international students. Students are encouraged to contact this Office prior to enrollment for assistance with application requirements and procedures. Contact the Office by phone at 215-968-8107 (V) or online at our website. [Link opens in a new browser window.]

Notice of Campus Security

The Security Information Report required by the College and the University Security Information Act of Pennsylvania and the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act of the Federal government is available through the Office of Security and Safety and other campus locations including our website. [Link opens in a new browser window.]